Patients who experience excessive sweating or hyperhidrosis in the axillary region are often treated with topical aluminum chloride or botulinum toxin therapy. If this solution fails them, axillary suction curettage may be an option. This minimally invasive outpatient surgery is commonly performed as a "last resort" for those that do not respond to any other therapy. The surgery is performed by curetting and vacuuming the sweat glands to reduce or stop excess underarm sweating. The procedure is designed to damage and remove as many sweat glands in the armpits as possible. This should result in the permanent reduction of excessive sweating.
How Axillary Suction Curettage Is Performed
Axillary suction curettage is often performed by a dermatologist. A tumescent anesthetic is injected into the skin, usually consisting of lidocaine, adrenaline and sodium chloride. A biopsy will then be taken of the hyperhidrotic area. Two incisions will be made into each axillae, and a canula will be inserted to curett and vacuum the sweat glands. The canula is small, and a circular-shaped loop on the end is used to scrape away the sweat glands from the underside of the skin. The incision sites are then sutured. After the surgery, bandages will be applied and patients will receive antibiotics and instructions for care.
What to Expect
There may be some pain, discomfort, swelling or limited mobility at the incision sites for up to two weeks. Bandages should be changed often, and antibiotics are usually scheduled for 5 days prior to the surgery. After 14 days, the wound is assessed and sutures are removed. Your dermatologist may discuss side effects such as bleeding or pain. Loss of feeling may occur, and the results are not guaranteed. This is because the sweat glands are too small for the surgeon to see. Patients should limit their activity, especially sports and exercise, for at least one week.
After one month, patients are evaluated for reduction in excess sweating, and measurements of sweat are performed so the success of the procedure can be recorded. The assessment may be performed again in 6, 12 and 24 months after the surgery. Some sweat glands that remain may still produce excess sweating, but the sweat glands that are removed or damaged will remain so permanently.
Insurance and Payments
Since surgical options for hyperhidrosis and excessive sweating are not recognized by most insurance companies, oftentimes the cost of the procedure must be paid out of pocket. It can range in price from $1,500 to $2,500, depending on your location and dermatologist. Some insurance companies do cover the cost in a few instances, such as a severe condition with failure of all other treatments. Look for an experienced dermatologist who has performed this surgery successfully in the past.